Home Health Clinical Reviewer

5 hours ago

Remote, India Trinity Publishing Service Pvt Ltd Full time

We are seeking an experienced and detail-oriented **Home Health Clinical Reviewer** with expertise in **ICD-10 coding, OASIS-E assessments, and Plan of Care (POC) reviews** at Levels 2 and 3.

This role plays a critical part in maintaining quality care standards while supporting operational efficiency in our home health program.

**Key Responsibilities:1. ICD-10 Coding**
- Assign accurate **ICD-10-CM diagnosis codes** for home health episodes in accordance with CMS and agency guidelines.
- Ensure coding supports medical necessity and aligns with the Plan of Care.
- Validate primary and secondary diagnoses for accuracy and compliance.

**2. OASIS-E Review**
- Review **OASIS-E assessments** for completeness, accuracy, and compliance with CMS guidelines.
- Identify and correct inconsistencies in assessment data and documentation.
- Provide feedback to clinicians to improve accuracy and quality of OASIS submissions.

**3. Plan of Care (POC) Review - Level 2 & 3**
- Review POCs for regulatory compliance, patient-centered goals, and accurate service frequency.
- Ensure care plans reflect patient needs, functional status, and physician orders.
- Collaborate with field clinicians to resolve discrepancies and clarify orders.

**4. Quality & Compliance**
- Maintain up-to-date knowledge of **CMS regulations and PDGM** requirements.
- Perform internal audits of documentation to ensure compliance and accuracy.
- Support clinical staff education on documentation and coding best practices.

**Qualifications & Requirements**:

- Minimum **2-3 years** in home health coding, OASIS review, and POC preparation.
- Strong understanding of **PDGM** and CMS compliance requirements.
- Proficient in **ICD-10-CM coding guidelines** and sequencing rules.
- Expertise in **OASIS-E** data sets and scoring.
- Detail-oriented with strong analytical and problem-solving skills.
- Excellent communication and collaboration skills.
- Proficiency with EMR/EHR systems (e.g., Kinnser).

Pay: Up to ₹600,000.00 per year

**Benefits**:

- Work from home

Work Location: Remote

Expected Start Date: 01/09/2025

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